Individual
ASIA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 MADISON ST, EVERETT, WA 98203-4543
(425) 212-4200
(425) 212-4220
Mailing address
11002 FORBES CREEK DR APT R207, KIRKLAND, WA 98033-5071
(206) 473-2997
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
MFTA.MG.70033132
WA
Other
Enumeration date
04/28/2022
Last updated
12/12/2025
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